Efficacy of constraint-induced therapy on functional performance and health-related quality of life for children with cerebral palsy: a randomized controlled trial.

To better generalize training effects to the context of daily living, home-based constraint-induced therapy has been proposed. Therapeutic success of constraint-induced therapy is limited as to whether the improvements in functional performance can be transferred to quality of life. This randomized controlled trial aimed to investigate the efficacy of home-based constraint-induced therapy on functional performance and health-related quality of life. Twenty-two children with spastic unilateral cerebral palsy (6-8 years, 10 boys) were randomly assigned to receive constraint-induced therapy or traditional rehabilitation. Home-based constraint-induced therapy had immediate and maintaining effects on motor efficacy and functional performance and induced greater gains in health-related quality of life in the long run than in the short term. The home-based constraint-induced therapy protocol (relatively moderate intensity and shortened constraint time), which might balance the effectiveness and compliance of participants and caregivers, may be an effective alternative to conventional constraint-induced therapy.

Influence of magnetic knee wraps on joint proprioception in individuals with osteoarthritis: a randomized controlled pilot trial.

OBJECTIVE: To determine the effects of magnetic knee wraps (MKWs) on joint position sense (JPS) in individuals with mild-to-moderate knee osteoarthritis. DESIGN: Randomized, double-blind, placebo-controlled pilot trial. SETTING: Rehabilitation clinic of a tertiary hospital. SUBJECTS: Fifty volunteers with mild-to-moderate knee osteoarthritis participated and 33 (66%) completed the trial; only one (2%) withdrew due to study-related adverse effects. INTERVENTIONS: Knee wraps with a static magnetic field (35 mT) were compared with control knee wraps for 12 weeks. MAIN MEASURES: The main outcome measure was JPS at first, fourth, and twelfth week while applying of the knee wrap, quantified as the ability to replicate target knee joint angles. The secondary outcome was the Comprehensive Osteoarthritis Test (COAT) total score. RESULTS: In the intention-to-treat analysis with an alpha-level of 0.05, 12-week application of the MKWs did not significantly reduce the mean absolute error (MAE) of JPS (n = 18; P = 0.627); contrarily, the MAE was found to decrease significantly after wearing the sham MKWs (n = 20; P = 0.01). The COAT total score gradually improved in both groups (P < 0.05). When comparing the improvement of MAE and COAT total score at each follow-up between two groups, no significant differences were found; the maximal difference in the improvement of MAE between two groups was noted at week 12 (mean difference: 1.2°; 95% confidence interval -0.4 to 2.9; P = 0.144). In the per-protocol analysis, the study group showed better improvement in the COAT total score at week 12 (P = 0.033). CONCLUSION: The 35-mT MKWs could not significantly influence knee JPS in individuals with mild-to-moderate knee osteoarthritis.

Effect of magnetic knee wrap on quadriceps strength in patients with symptomatic knee osteoarthritis.

OBJECTIVE: To determine the effects of magnetic knee wrap on isokinetic quadriceps strength in patients with painful knee osteoarthritis (OA). DESIGN: Randomized, double-blinded, placebo-controlled and before-after trial. SETTING: Rehabilitation clinic in a tertiary hospital. PARTICIPANTS: Eligible patients (N=50) (mean age+/-SD, 66.0+/-8.6 y) with mild to moderate knee OA were recruited from the outpatient department and 37 (74%) completed the trial. Only 3 (6%) withdrew due to study-related adverse effects. INTERVENTIONS: Wearing the active (n=24) or sham (n=26) magnetic knee wrap for 12 weeks. MAIN OUTCOME MEASURES: The primary outcome measure was isokinetic quadriceps strength. Secondary outcome measures included the Health Assessment Questionnaire Disability Index (HAQ-DI) and the Health Assessment Questionnaire (HAQ) Pain Scale. RESULTS: Using intention-to-treat analyses, the peak isokinetic quadriceps strength increased significantly in the treated leg at 30 degrees/s (P=.007) and 60 degrees/s (P=.022) after wearing the magnetic knee wrap. Compared with baseline, the median strength increase for the treated leg in the study group significantly exceeded that in the control group at week 4 (.05 Nm/kg vs -.09 Nm/kg at 60 degrees/s, P=.038) and week 12 (30 degrees/s, .09 Nm/kg vs .04 Nm/kg, P=.044; 60 degrees/s, .17 Nm/kg vs .02 Nm/kg, P=.031). The HAQ-DI and HAQ Pain Scales improved significantly in both groups. Compared with baseline, the improvement at week 12 in terms of the HAQ-DI in the study group significantly exceeded that in the control group. CONCLUSIONS: Magnetic knee wrap may significantly facilitate isokinetic quadriceps strength in patients with mild to moderate knee OA.